What's in a name?
by collections
Summary: "Casey wanted to name her that, and I'm going to honor it." A look at the sad events and happy flashbacks that lead up to the birth of the newest Venturi and her name choice. Still trying to get better at summaries. Please read & review!
1. Chapter 1

**Disclaimer: I do NOT own Life With Derek!**

 **Each chapter begins with a flashback. Flashbacks are in italics. Enjoy!**

* * *

 **Flashback:**

 _"Derek, I'm pregnant," Casey muttered as she sat on his bed. She was staring at the floor the whole time, off in space. The words just managed to find themselves out of her pouty lips._

 _"What?" Derek asked. Did he hear her right? His whole body went numb. Casey only nodded, keeping her eyes fixated on the floor in front of her._

 _"Five positive pregnancy tests and two blood tests from two different doctors," she slowly spoke, finally looking up at him. His face was solid, his mouth set in a straight line. After what seemed like 50 years, Casey spoke up. "D, say something, please." Derek's mouth opened, but nothing came out._

 _"Are you going to keep it?" Derek uttered quietly, his eyes moving from her face to her abdomen. Casey leaned forward, her arms resting on her knees._

 _"That's kind of a two person decision. Mom_ and _dad," she said._

 _"Oh, so if I decide I didn't want the kid, you'd just get rid of it? Or Vice Versa?" Derek didn't mean to snap at her, but how she seemed so relaxed about their situation angered him. Casey flipped out about the smallest things, but when it came to something as big as bringing a child into the world, she was so_ calm _._

 _"No, Derek. I'm going to do what I want to do, regardless. I just figured I'd get your input. Possibly secure my decision," Casey retorted, leaning back onto his bed propping herself on her elbows._

 _"And what is your decision?" Derek asked. He was leaning up against the wall in the small bedroom of his apartment. Casey stayed quiet for a minute, chewing her lip. She had never said her decision out loud. So she leaned up, took a deep breath, and looked him square in the eye._

 _"I want to keep it."_

* * *

 **Present:**

"You're doing great Casey, keep pushing," Nora Venturi encouraged as she watched her eldest daughter give birth to her first grandchild. Casey groaned through gritted teeth before relaxing for a few seconds, breathing heavily.

"Excellent Casey, get ready to push again. One more big push," the doctor instructed, his hands getting ready to deliver the soon to be youngest person in the world. Casey leaned her head back on her pillow, letting out a painful and exhausted cry. She looked up at her child's father, her eyes pleading with him.

"I can't do it, D, I just can't do it," she cried to him, her eyes closing as a few salty tears rolled down her cheeks. She was really regretting passing on the epidural when it was offered. Her cheeks were flustered red, and her forehead was beaded with sweat. Derek Venturi gripped her hand harder, leaning down to whisper into her ear.

"You can do it Case, I know you can. You're so strong and proud, I know you can do this," he spoke softly to her before pressing a soft kiss to her temple. "I'm right here, I'm not going anywhere. You're almost there, we're going to meet our baby." This seemed to be the motivation Casey needed, she opened her baby blue water eyes and gave him a nod. She looked at the doctor, taking a deep breath when he motioned and began to push again.

"That's it Case, 10…9…8…7…" he began to count down as the child's head slipped into his hands. He grabbed the babe's shoulders, pulling out a newborn baby girl. "It's a girl!" With this announcement, he gave the baby a small smack on the bum and her cry pierced the room. He immediately placed the baby on Casey's chest, allowing the new mother to look at her daughter.

"You did it Casey! Baby, you did it," Derek smiled wide at his crying daughter, his own brown eyes beginning to form with tears. His hand went out to softly touch his daughter's fingers. He looked over to Casey with a smile on his face, but it quickly dropped when he noticed her comatose state. "Casey?"

The next few moments were a blur to him. One of the many monitors above their heads began to beep in a panicked tone. His newborn's daughter scream seemed to move away as the nurse picked her up and carried her away. More nurses swarmed Casey, one beginning to pull at Derek. All he could do was stand in shock, watching the scene unfolding in front of him.


	2. Chapter 2

_"Stop fidgeting, you're driving me crazy," Casey mumbled under breath as she flipped through one of the many waiting room magazines._

 _"Seriously, how can you be so calm about everything?" Derek turned to look at her, his head leaning against the wall behind him. He was slouched in the chair, his foot tapping the ground at about a million miles a minute. Or at least, that's what Casey felt it was. She closed the magazine and looked over at him._

 _"I did all of my freaking out when I realized I was late," she whispered to him, coldness in her voice. "Then I realized if I wanted to keep the baby, I had to quit making everything about me. Maybe you should do the same," she cut coldly to him, turning back to her magazine and opened it again._

 _Derek only sighed and turned his head back to stare up at the ceiling again. As much as hated to admit it, Casey was right. When she told him she wanted to keep the baby, he was happy – although it took him a couple of days to realize it._

 _He worried about what his dad and Nora would say when they found out - not that they really needed their permission. Casey and him had been 'together' for the past 3 years. It had started out as just sex in their senior year of college. They finally gave into the sexual tension that terrorized them for the past 6 years. But along the way, it developed into something more._

 _No, they weren't in an official relationship. But when boys offered to take Casey to lunch or carry her bag of graduate school textbooks, she politely declined. And when girls threw themselves at Derek after his hockey games, or flirted with him at the office, he didn't give them the time of day. They spent most of their time at Derek's apartment, since Casey had a roommate with a boyfriend. She even had a few drawers of extra clothes and even an extra toothbrush at his place. But still, they got their mail at two different places._

" _First child, eh?" a voice snapped Derek out of his thoughts. He looked across from him and saw a woman with a swollen stomach and a wide smile. Derek gulped._

" _How can you tell?" He asked, his foot sitting still for a few moments. Casey sighed out in relief next to him, her head still down._

" _The rabbit foot you have, and the look of fear and worry across your face," the woman giggled, leaning back into her own chair. "My husband was the same way. Terrified of having to be responsible for a living child. But he got over it, and now we're on our fifth! How long have you two been together?" Derek was ready to open his mouth and tell her '3 years' when Casey's voice spoke instead._

" _We're not together, actually," she spoke softly to the woman. Derek turned to look at her. No they weren't official, but he didn't think she'd be so blunt honest with a woman who didn't know them or their story. Derek turned back to the woman to see her face was struck with an awkward smile._

 _"Well, don't worry. A child can bring their parents together like never before," she smiled reassuringly at them. Derek flashed her a slight smile and nodded._

 _"Cassandra McDonald?" the nurse from the open door called, clipboard in hand. Derek breathed out relief as Casey stood up, and he followed. The nurse led them to a small room with a leather cot. She gave Casey a pink hospital robe and said she'd be back in a few minutes. Casey twirled her fingers, signaling to Derek to turn around while she changed. He opened his mouth to argue that he had seen her naked many times before, but just chose to put his hands up in defeat and turn around._

 _"Why did you tell that lady we weren't together?" Derek asked once Casey was lying back on the cot and they waited for the nurse to return. Casey shrugged, looking at the wall in front of her._

 _"Why say something that isn't true? I've been lying to myself for so long, I don't need to be lying to others," she spoke softly. Derek had to blink and look at her. Where the hell was this coming from?_

 _"Casey, what in the world are you talking about?" He asked as he reached out to touch her arm. She jerked it away and looked at him with watery blue eyes._

 _"Don't. Don't act like this was more than just sex. Don't act like we're in love. Don't act like we're together," she emphasized the last word, looking at him. "3 years and we haven't told my mom, or your dad. I'm not allowed to touch you when we're around them, and I have to throw out an insult everyday when we're home for Christmas. I can't even tell my coworkers that my boyfriend and I are having a baby! I'll have to tell them I got knocked up by my fucking_ step-brother _!" she cried to him, looking back at the wall. She sobbed before closing her eyes, and taking a deep breath._

 _Derek sat in the chair next to her, with no words able to come out of his mouth. How could he have known Casey felt like that? How could he not? Everything she said, every single word was true. And as he looked at her crying self, the only thing he wanted to do was hold her; to stroke her hair, and kiss her forehead. But he knew she'd never let him touch her._

 _They sat in silence for the next couple of minutes. Derek starred at the floor, and Casey regulated her breathing and dried her cheeks. Then the door opened and a cheerful technician walked in._

 _"Alright, Miss McDonald, thank you very much for waiting," she smiled at Casey as she walked towards her. She must have noticed her watered and swollen eyes, but she didn't say anything. Instead she pulled up her stool and began the sonogram. Casey and Derek didn't say a word during the entire set up. Casey only spoke to answer the technician's questions, and Derek kept his eyes fixated on the screen in front of them._

 _Soon, the screen showed a black and white filtered picture. He had seen enough Facebook posts and sonograms of Edwin and Marti to know it was Casey's womb. There was a black oval in the middle, and inside of it was a small gray bean._

 _"There we go, there's your baby," the technician smiled at both of them, looking between the two to get a reaction._

 _"That's it?" Derek spoke up, never taking his eyes off the screen. The technician nodded with a smile at him._

 _"Mmhmm, that's it! You're only six weeks along, that's why it doesn't exactly look like a baby," she turned and spoke to Casey. "Let's hear that heartbeat, what do you say?"_

 _Casey smiled at the nurse and nodded, then turned her attention back to the screen. It was a picture of her baby. Well, their baby. She looked at Derek; he seemed so fascinated and amazed. This brought a whole new set of emotions over her, and she couldn't hold back the tears. No matter what would come from their 'relationship', he was the father of her child. And that would never change._

* * *

"Sir, we need you to step outside," the nurse who pulled at Derek's upper right arm spoke and finally snapped him out of his trance. He never took his eyes off Casey as he found his voice.

"Casey? Baby, it's going to be okay! Case!" he yelled over the commotion and chaos the delivery room has now turned into.

"Derek, you have to come with me," Nora spoke calmly as she stepped in and pulled him away from Casey. The nurses swarmed Casey's limp body and began to shout foreign medical words around the room, but Derek didn't budge. "Derek, come on, they're going to make sure she's okay." It took Nora and two more nurses to finally pull him away. The whole time, it felt like his limbs were numb and he was just watching the scene unfold.

"Sir you have to wait out here, we will let you know what's happening," one of the nurses said to him before she disappeared back into the delivery room. He stood there, staring at Casey before the slamming door broke the connection. When he blinked his eyes, he wanted to punch the wall for making him leave the room. He balled up his fists and began to pace the small hallway. Watching the door, he ransacked his brain for any reason to bust into room.

"Come on Derek, let's just go wait. She's probably just exhausted and her body gave out. She's been up all night and all morning," Nora said, trying to convince Derek everything was going to be all right. But in reality, she was actually trying to convince herself. Derek was going to protest, to tell Nora that he wanted to stay right there until Casey was okay, but he felt his feet walking with her as she pulled him away.

They reached the waiting room where the rest of the family and friends were. They had all dropped everything to come for the birth of the much-anticipated Venturi baby. George, Lizzie, Edwin, Marti, Sam, Emily, Ralph, and Casey's dad. Derek's mom, Abby, was even there, along with her new husband, Joel. They all stood up when Nora and Derek walked in. Her arm was around his shoulder, holding him close and guiding his steps. The waiting room's occupant's smiles and excitement dropped when they saw their somber faces and Nora's teary eyes.

"What happened? Is the baby okay?" Lizzie asked. She was always the shy one, but when it came to her older sister, she really didn't have a filter.

"The baby's okay, Liz. She's nice and healthy, and has a powerful set of lungs," Nora started, forcing a smile as she looked over at Derek. But he was only staring at the floor, a million thoughts running through his mind.

"So what's the problem?" Marti bluntly asked. Derek would usually laugh and make a comment about how his Smarti was the back bone of the family, but right now he didn't have a single joke inside of him.

Derek pulled himself away from Nora and walked to the window of the waiting room. He could see the tears welling up in his eyes in his reflection, but he just looked through it to the outside world. There were people walking from the hospital to their cars, and vice versa. Cars passed the giant building, going on with their day-to-day lives. They were probably stressing about rent, or their bosses laying into them at work, or any small trivial thing. He'd give anything to trade worries with them.

It seemed like hours had passed. Everyone settled into a waiting room chair, refusing to move until they received news of any kind. Derek stared out that window for 50 whole minutes. He didn't even care the sun was blinding him, or that his legs were throbbing because they hadn't moved. He could only think of Casey. And suddenly, his thoughts were interrupted.

"Family for Casey McDonald?"


End file.
